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SIBO And Migraines: Is There A Connection?

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Welcome to my blog post ‘SIBO, Headahces And Migraines: What’s The Connection??’.

You may also be interested in the section of my blog dedicated to gut health, click here, in particular:

Does SIBO Cause Migraines?

Recent studies suggest that migraine may be associated with gastrointestinal disorders, including irritable bowel syndrome (IBS), inflammatory bowel syndrome, and celiac disease (1).

Besides gastrointestinal diseases, the gut microbiota as an independent factor can also contribute to systemic diseases. This can be caused by (1):

  • The migration of stimulated immune cells
  • Systemic diffusion of microbial products or metabolites
  • Bacterial translocation as a result of decreased intestinal barrier function (ie leaky gut).

The brain and the gut are strongly connected via neural, hormonal, metabolic and immune pathways. The communication occurs in two directions, not only from the brain to the gut but also the other way around.

This recent finding on the role of the gut microbiota in the gut-brain axis suggests that the gut microbiota can be associated with brain functions and neurological diseases like migraine

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Headaches And Gut Health

Not all observational studies are restricted to migraine. The HEAD-hunt study, for example, looked at the relationship between gut symptoms and headache, including migraine.. The study was a questionnaire-based cross-sectional study among more than 51,000 inhabitants of a county in Norway. The study showed a higher prevalence of headaches among people who regularly experience gut symptoms compared to the control group without gut complaints. The association between headache and gut complaints increased with increasing headache frequency. All the gut complaints were as common among persons with non-migrainous headache as among migraine patients. So both migraine and other types of headaches are more common in people with GI complaints.

A study among approximately 125,000 IBS patients, identified in a large national health insurance database, found a prevalence of migraine of 60 per 1000 against 22 per 1000 in a control population from the same database. After correction for gender and age, and stratification of the mean monthly total medical cost, the odds for being diagnosed with migraine were 60% higher for people in the IBS cohort compared to people in the non-IBS cohort

Migraines And Gastroparesis

Gastroparesis is a chronic disorder manifested by delayed emptying of the stomach.

Gastroparesis is a relatively common complication of diabetes. In a population of patients with symptoms of diabetic gastroparesis, the patients with cyclic symptom patterns had a higher incidence of migraine headaches compared to patients without cyclic vomiting pattern. Migraine attacks are associated with delayed gastric emptying. This migraine-associated gastroparesis is a problem for the treatment of the migraine with oral medicines, like oral triptans. Initially, delayed gastric emptying was found during migraine attacks, now there are also indications that in the interictal periods migraine patients have delayed gastric emptying. However, the studies done so far have been small and inconsistent in their results, so further research in this topic is warranted.

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Leaky Gut And Migraines

In intestinal disorders characterized by an increased intestinal permeability like IBS, IBD, and celiac disease enhanced pro-inflammatory immune responses have been reported. Enhanced levels of pro-inflammatory immune cells in serum of migraine patients have been found during migraine attacks. These cytokines can act on the pain receptors of the trigeminal nerve, causing migraine.

Also statistical significant associations have been reported between migraine and a wide range of inflammatory disorders like asthma, obesity, metabolic syndrome, allergies, and GI diseases. A strong trigger of pro-inflammatory immune responses is the leakage of lipopolysaccharides (LPS) from the intestinal lumen into the circulation. Enhanced levels of LPS can enter the circulation when the intestinal permeability is increased

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References:

  1. Migraine associated with gastrointestinal disorders: review of the literature and clinical implications: click here.
  2. Gut-brain Axis and migraine headache: a comprehensive review: click here.
  3. Gastrointestinal disorders associated with migraine: A comprehensive review: click here.
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